The present invention generally relates to the management of pain associated with applying electrical cardioversion therapies. In particular, the invention relates to patient preparation in advance of application of the electrical cardioversion therapy.
Implanted medical devices are capable of detecting and treating an arrhythmia (i.e., irregular heartbeats) in a patient. In one example, the implanted medical device includes a defibrillator that applies an electrical pulse therapy to a patient""s heart upon detecting fibrillation (i.e., high, irregular heartbeat), a form of arrhythmia. Cardioverters or defibrillators discharge relatively high energy electrical shocks or pulses into or across cardiac tissue to arrest a life-threatening atrial or ventricular fibrillation upon detection by the implanted medical device. Defibrillation shocks, while highly effective at arresting the fibrillation, may occur suddenly and can cause considerable patient discomfort.
The level of discomfort that a patient experiences with defibrillation shocks is affected by many psychological factors, among which are fear and anxiety of the impending shock therapy. In one instance, the patient becomes highly distressed because the patient must rush through current activities in order to find an area for treatment, and await the application of the pre-programmed shock therapy. Patients can reduce the impact of these psychological factors by taking control over the time that the shock is applied and by physiologically preparing the body in advance of the shock delivery.
The implanted device is programmed by a physician using a programming head that is electrically connected to a programming unit similar to a personal computer. The programming of the implanted device is usually limited to the physician or a trained technician. To safeguard the patient""s health, the physician programs the implanted device to automatically deliver at least one electrical shock therapy in a 24-hour period. Therefore, patient control over the application time of the shock treatment is not usually available to ambulatory patients because the patient is not authorized to program his own implanted device.
Patients can also reduce the impact of psychological factors by using any one of a number of sedatives prior to the shock delivery. Although sedation therapy may be helpful in reducing shock discomfort, sedation therapy is also impractical when the patient is traveling or when the patient needs to be alert and cannot be incapacitated by the sedative for a prolonged time period.
Accordingly, patients would be able to better manage the pain associated with electrical cardioversion therapy if they had the time to psychologically and physiologically prepare in advance of the therapy. An approach that addresses the aforementioned problems, as well as other related problems, is therefore desirable.
Various embodiments of the present invention are directed to addressing the above as well as other needs in connection with enabling a patient to control the pain associated with an electrical cardioverting therapy, by allowing the patient to control the timing of the electrical therapy. In one such embodiment, an implanted medical device is configured to automatically cause the application of an electrical therapy at least once within a selected period (e.g., 24-hour period), includes a circuit arrangement for temporarily disabling the electrical therapy application responsive to a patient activated device that is carried by the patient.
According to another embodiment of the invention, a system for temporarily disabling an electrical therapy application by an implanted medical device includes a capacitive circuit capable of charging and discharging in order to apply the electrical therapy. The implanted medical device automatically causes the capacitive circuit to charge and discharge at least once within a selected period. The system includes a patient activator device that communicates with the implanted device. A disabling circuit is also included within the implanted medical device that temporarily disables the electrical therapy application in response to the patient activator device. The system further includes an alerting arrangement that alerts the patient activator device in response to the disabling circuit. The system also includes an override circuit that overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.
According to yet another embodiment of the present invention, an implanted medical device that automatically applies an electrical therapy to a patient""s heart at least once within a selected period includes a communications circuit that enables telemetric communications from the implanted medical device in response to an external patient activator device. A disabling circuit is disposed within the implanted medical device that temporarily disables the electrical therapy application. An alerting arrangement is also include that alerts the patient activator device in response to the disabling circuit. The implanted medical device further includes an override circuit that overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.
The above summary of the present invention is not intended to describe each illustrated embodiment or every implementation of the present invention. The figures in the detailed description that follow more particularly exemplify these embodiments.